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Form No f370 1 Kyc 06 07 2020 E58cc565fe

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21 views2 pages

Form No f370 1 Kyc 06 07 2020 E58cc565fe

Uploaded by

dalanjalar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Know Your Customer (KYC) Profile Form(Individual/Joint)

(Requirement in terms of Financial Transaction Reporting Act No 6 of 2006)


DATE :
A/C NO :
BRANCH NO :
OFFICER NO :
SIGNATURE :
(Branch Manager/Assistant Manager/Head of Department)

Section A – Basic information of the individual including of those with Power of Attorney.
✓ Tick the appropriate boxes
1. Name in full: 2. Date of Birth:

3. Nature of business : 4. Occupation/Employment/Status:

5. Name & Address of Employer : 6. Position held:


( Director/Partner/Major Shareholder/Office Bearer etc.)
7. Citizenship :
 Sri Lankan Nationality
 Sri Lankan with dual citizenship Type of Visa
 Sri Lankan with foreign citizenship
 Foreign national Expiry date
8. Foreign Address (if any):

Section B -Mandatory Checks


✓ Tick the appropriate boxes
1. Name, Date of birth and Nationality verification:
To be supported by one of the following accepted documents
 National Identity Card No (……………………….)  Valid Driving License No (…………………….)
 Valid Passport No (…………………….)  Others(specify)
 Postal Identity/Birth Certificate for minor (…………………)
2. Address verification: Residential address verified and supported by one of the following accepted documents
(N.B.- Mobile Phones Bills are not accepted)
 National Identity Card  Utility Bill not over three months’ old  Income Tax Receipt/ Assessment Notice
 Tenancy Agreement (Electricity/Water/Fixed Phone)  Letter from a public Authority
 Valid Driving License  Employment Contract  Others (Specify)

N.B.- Under item 1 & 2, a copy should be held & stamped “Original Seen”

3. Status of the Residential Address: : Premises


 Owner  Lease/Rent  Friends/Relatives
 Parent’s  Official  Board/Lodging
Permanent Address:

4. Geographical Area:
Customer is residing within a reasonable distance to the Branch? Yes No

If not the Reason for opening an account at the branch :


5. Applicants’ Ownership of Wealth and Estimated Value:
 Residential property  Financial assets
 Business premises  Investments
 Motor vehicles  Others (Specify)
(If property is on rent/lease, please indicate)
6. Source of Wealth : Wealth generated from
 Business ownership  Inheritance
 Investments  Others (specify)
 Profession/employment
Information & Account Profile Form
1. A/C Type  Savings A/c  Treasury Bill/Bonds
 Current A/c  Foreign Currency A/c
 Fixed/Call Deposit A/c  Others (Specify)
 Money Market A/c

2. Purpose for opening the account & the usage


 Business transactions  Bill payment/Loan repayment  Investment purposes
 Salary/Professional income  Savings  Donations/Charities(Local/Foreign)
 Remittances  Share transactions  Others (Specify)

3. In case of Foreign Passport Holders, give the purpose of opening the account in the foreign jurisdiction:

4. Source of Funds:
Expected source and nature of credits into the account
 Sales and business turnover  Contract proceeds  Sale of Property/Assets
 Family remittances  Donations/Charities (Local/Foreign)  Gift
 Rent Income/Commission Income  Salary/Profit/Professional Income  Membership Contribution
 Export Proceeds  Investment Proceed  Others (Specify)
5. Expected Monthly Turnover :
Expected/Usual average volumes of deposits into the account in Rs per month
 Less than Rs. 50,000 (or equivalent FC value)  Rs. 1,000,000 to Rs. 5,000,000(or equivalent FC value)
 Rs. 50,000 to Rs. 100,000 (or equivalent FC value)  Above Rs. 5,000,000 (or equivalent FC value)
 Rs. 100,000 to Rs. 500,000 (or equivalent FC value)
 Rs. 500,000 to Rs. 1,000,000 (or equivalent FC value)

6. Expected Mode of Transactions/ Delivery Channels :


 Cash  Fund Transfers  Others (Specify)
 Cheques  Remittances

7. Other Connected Business/Professional activities & interests

8. Expected Types of Counterparties (if applicable)

9. Are you or your close relative a Political Exposed Persons (PEP)? Yes No

If “YES”- Please Specify :

10. Other Details/Remarks/Notes (if any):

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………………………………. … …….......……………
Signature of Applicant Date

FOR BANK USE ONLY

Account Number :

….………………………………. ……………………………………………………. ………………………….

Signature of Authorized Officer Name Date

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